Prevalence Of Stress Urinary Incontinence Research Articles

Prevalence of Stress Urinary Incontinence after Vaginal Hysterectomy in Eastern Nepal

Introduction: Pelvic organ prolapse is reproductive health morbidity in our country and vaginal hysterectomy is one of the most commonly performed surgery. Urinary incontinence is a common problem after hysterectomy.
 Objective: This study assesses the prevalence of stress urinary incontinence after vaginal hysterectomy and the factors associated for stress urinary incontinence after hysterectomy.
 Methodology: This is ahospital based descriptive prospective study conducted for a period of 1-year from January 2019 toJanuary 2020. All patients who underwent vaginal hysterectomy for pelvic organ prolapse were included in the study. Datawas recorded in Performa, and patients were followed up with telecommunication after a month of post-operative period regarding occurrence of stress urinary incontinence. Data were statistically analysed for mean, frequency and fisher’s exact test were done to find the association betweenstress urinary incontinence and risk factors.
 Results: A total of 100 patients were included in the study. Twenty-one (21%) patients complained of post-operative stress urinary incontinence. Stress urinary incontinence was not found to be significantly associated with vaginal hysterectomy, smoking habit, type of work or stage of pelvic organ prolapse. However, it was significantly associated with advancing age.
 Conclusion: Stress urinary incontinence was significantly associated with advancing age but the association with smoking habit, type of work, stage of pelvic organ prolapse was not statistically significant.

Development of Predictive Risk Models of Postpartum Stress Urinary Incontinence for Primiparous and Multiparous Women

Objectives: To develop risk predictive models of postpartum stress urinary incontinence (SUI) for both primiparous and multiparous women. Materials and Methods: From July 2016 to July 2017, 815 singleton pregnant women without incontinence before pregnancy who were 18 years or older and admitted to 2 hospitals in Shenzhen, China, were enrolled. Pregnancy-related data were collected at enrollment. Delivery information was obtained from electronic medical records. Telephone follow-up was conducted to investigate SUI at 6 weeks postpartum. Multivariable logistic regression analyses using stepwise selection were used to establish predictive models for postpartum SUI for all women, and separately for primiparous and multiparous. Internal validation of the models was performed with discrimination and calibration using a bootstrapping (1,000 resampling) method. Results: The analysis included 727 participants. The prevalence of postpartum SUI was 15.96% (116/727), 12.5% (49/393) for primiparous women and 20.1% (67/334) for multiparous women, with a significant difference between them (p = 0.008). For primiparous women, the predictive postpartum SUI model included age, abortion/miscarriage history, SUI during pregnancy, and mode of delivery. For multiparous women, pre-pregnancy BMI, abortion/miscarriage history, SUI during pregnancy, and mode of delivery were included in the model. There was satisfactory calibration between the models’ predicted probability of postpartum SUI and the observed probability for both primiparous and multiparous women (Hosmer-Lemeshow test, p = 0.390 for primiparous and 0.364 for multiparous women). The optimism-corrected C-statistic of the models by bootstrapping stepwise was 0.763 (95% confidence interval [CI]: 0.693–0.833) for primiparous women and 0.783 (95% CI: 0.726–0.841) for multiparous women. Conclusion: We developed predictive models of postpartum SUI for both primiparous and multiparous women. This approach may provide a useful tool for high-risk prediction of postpartum SUI before and after delivery.

Аналіз використання методу анкетування у дослідженні епідеміології стресового нетримання сечі у жінок: вплив на якість життя

The objective: to investigate the epidemiology of the stress urinary incontinence (SUI), and common lower urinary tract symptoms and the related quality of life among women of different age groups of the selected population by the questionnaire method. Materials and methods. Questionnaires of 49 women of all ages, who were not treated for urologic complaints at the time of the survey, were analyzed. The anamnestic part of the Petros questionnaire and short forms Urogenital Distress Inventory (UDI-6) and Incontinence Impact Questionnaire (IIQ-7) were selected for survey. The age distribution is based on qualitative age ranges recommended by WHO. Results. In all, 63% of women surveyed had complaints related with urinary disorders; the most common lower urinary tract symptom was SUI, which worried 41% of all women. The prevalence of SUI among women of different age groups varied: in young and mature women – 35%, significantly increased in middle-aged women and decreased in elderly women. All middle-aged and elderly women had lower urinary tract symptoms. Among the recognized risk factor for SUI was statistically significant cough (p<0.05) with an average association between risk factor and disease. About 61% of patients with urinary incontinence indicated that their symptoms affected quality of life. Conclusions. The analysis of the results of the questionnaire confirmed the feasibility of using UDI-6 and IIQ-7 in epidemiological studies of UI among women. The results of the work performed may be qualified as partial validation of the UDI-6 and IIQ-7 questionnaires in terms of assessing their reliability. Keywords: urinary incontinence among women, stress urinary incontinence among women, lower urinary tract symptoms among women, quality of life, risk factors, questionnaires.

Association Between Stress Urinary Incontinence and the Components of Metabolic Syndrome Among Females 20-59 Years

ObjectiveTo assess the relationship between stress urinary incontinence (SUI) and metabolic syndrome among a population-based cohort of women 20-59 years. MethodsNational Health and Nutrition Examination Survey database was used between the years of 2013 and 2016 and included women aged 20-59 years. SUI was defined as “Urinary leakage with physical activity.” Metabolic syndrome was defined as >2 risk factors: fasting blood glucose (FBG) >99 mg/dL, triglyceride >149 mg/dL, high-density lipoprotein <50 mg/dL, waistline >88 cm, and blood pressure >130/85. We generated weighted estimated prevalence and ran multivariable logistic regression models. ResultsAmong 3430 female subjects, the estimated prevalence of SUI was 38.7% (95% confidence interval [CI] 36.7-40.7%) and metabolic syndrome was 10.2% (95% CI 8.9-11.6). Higher rates of SUI were seen with large waistlines, elevated FBG, and elevated triglycerides. Among women with metabolic syndrome, 56.1% (95% CI 39.7-49.0%) had SUI. Among all women, metabolic syndrome and elevated FBG significantly increase the risk of SUI (odds ratio [OR] 1.53 [95% CI 1.02-2.28] and OR 1.86 [95% CI 1.14-3.03], respectively). In women 20-39 years, a large waistline significantly increased the risk of SUI (OR 1.72 [95% CI 1.00-2.99]). ConclusionAmong females 20-59 years in the United States, 38.7% report SUI and 10% have metabolic syndrome. Metabolic syndrome and an elevated FBG significantly increase the risk of SUI among all women. A large waistline increases the risk of SUI in women aged 20-39 years. Weight loss and adequate control of metabolic syndrome should be considered key strategies in the management of SUI.

Prevalence of Urinary Incontinence in High-Impact Sport Athletes: A Systematic Review and Meta-Analysis.

The aim of this study was to systematize the scientific evidence that assessed the prevalence of urinary incontinence in female athletes and determine which modality is most predisposed to stress urinary incontinence. From September to December 2018, a systematic literature search of current interventional studies of stress urinary incontinence of the last ten years was performed using PubMed, EMBASE, Scopus and Web of Science databases. The methodological quality was assessed by the Downs and Black scale, while the data collected from the studies were analyzed through meta-analysis. Nine studies met the eligibility criteria, meaning they included reports of urinary incontinence in different sports. The meta-analysis showed 25.9% prevalence of urinary incontinence in female athletes in different sports, as well as 20.7% prevalence of stress urinary incontinence. The most prevalent high impact sport was volleyball, with the value of 75.6%. The prevalence of urinary incontinence can be high in female athletes, with high-impact sports potentially increasing the risk for stress urinary incontinence. Further research is needed regarding the potential risk factors related to the onset of urinary incontinence.

Comparison of stress urinary incontinence between urban women and women of indigenous origin in the Brazilian Amazon.

This study compared two populations in the Brazilian Amazon, one comprising urban women and the other indigenous origin women from a riparian population, to assess the prevalence of and risk factors associated with stress urinary incontinence (SUI). Following sample calculation, 120 indigenous and 260 urban women underwent evaluations including medical history, UI-oriented physical examination, pelvic organ prolapse, and functional assessment of the pelvic floor. Women with complaints of SUI underwent a urodynamic study and completed a quality of life questionnaire (King's Health Questionnaire). Univariate ORs were calculated, and multiple logistic regression models were then built using the stepwise backward method. The prevalence of SUI was similar in both groups (25.8% in indigenous origin women and 20.4% in the urban group (P > 0.05). The parity and number of spontaneous deliveries and home births were higher in the indigenous origin group. Multivariate analysis showed a decreased prevalence of SUI in patients with modified Oxford Scale scores ≥ 3. Women with homebirths had a 3.45-fold higher likelihood of having SUI than women with hospital deliveries (OR 3.45 -CI 1.78-6.70). Quality of life was worse in the domains of SUI impact, hindering daily and physical activities as well as jeopardizing personal and emotional relationships in urban women. No significant difference in SUI was observed between the groups, despite significantly higher risk factors for SUI in the indigenous origin group.

RETRACTED ARTICLE: Inducible nitric oxide synthase promotes differentiation of satellite cells and prevents stress urinary incontinence via HGF-mediated p38/MAPK signaling.

Satellite cells (SCs) are multipotent skeletal muscle precursor cells, which can lead to muscle regeneration, a crucial process for the treatment of stress urinary incontinence (SUI). The activation of SCs is likely to be caused by inducible nitric oxide synthase (iNOS). This study examines the underlying mechanism of iNOS in SC activation, and the implications of a potential treatment of SUI. SCs were isolated from the levator ani muscles of rats, followed by measurement of iNOS, paired box gene 7 (Pax7) and myosin D (MyoD) protein expression. Flow cytometric and cell counting kit-8 assays were conducted to assess SC proliferation, apoptosis, cell cycle distribution. SC myotube formation was observed under a light microscope. A rat model of SUI was established using vaginal dilation and bilateral ovarian castration, followed by assessment of leaking point pressure (LPP) and a sneezing test. The levels of MyoD, Pax7, hepatocyte growth factor (HGF) and p-38 in the levator ani muscles were detected by immunohistochemical and western blot analyses. SCs successfully isolated from rat levator ani muscles showed increased MyoD and reduced Pax7 expression. Upregulation of iNOS promoted differentiation and myotube formation of SCs. iNOS elevated the expression of HGF, which in turn activated the p38/MAPK signaling pathway, promoting the differentiation of SCs. SCs overexpressing iNOS increased LPP, thus preventing SUI in an in vivo rat model. Our results show that iNOS could activate the HGF-dependent p38/MAPK signaling pathway to alleviate SUI, potentially providing a novel therapeutic strategy for SUI.

Stress urinary incontinence after transvaginal mesh surgery for anterior and apical prolapse: preoperative risk factors.

Debate persists over whether surgery to correct pelvic organ prolapse (POP) should be combined with midurethral sling (MUS) insertion. The aim of this study was to evaluate the incidence of stress urinary incontinence (SUI) up to 12months after transvaginal mesh surgery, with or without MUS, and to identify risk factors for postoperative SUI. This retrospective single-center study included patients who underwent transvaginal mesh surgery with Uphold™ between October 2010 and December 2017. The primary outcome was the prevalence of SUI at 12months postoperatively. Univariate and multivariate logistic regression was used to identify risks factors for postoperative SUI. Of the 308 women included, 123 (40%) were continent (no SUI), 108 (35%) had SUI, and 76 (25%) had occult SUI. Forty-nine patients (15.9%) had a concomitant MUS procedure. At 12months after surgery, 35.9% of patients without concomitant MUS had SUI vs 14.3% with (p= 0.003). Thirty-five patients (29%) developed de novo SUI. Postoperative complications were more common in patients with concomitant MUS (30.6% vs 17%; p= 0.003). The best predictor of postoperative SUI was the presence of preoperative SUI (OR 2.52 (1.25-5.09). Concomitant MUS (p< 0.001), and prior POP surgery (p= 0.034) were protective factors for postoperative SUI. Preoperative SUI is the most important risk factor for postoperative SUI. However, given the higher risk of postoperative complications with concomitant MUS and the acceptable rate of de novo SUI rate without it, two-stage surgery seems preferable for patients with preoperative SUI.

What is the prevalence of stress urinary incontinence in female athletes?

What is the prevalence of stress urinary incontinence in female athletes?

The Influence of Early Exercise Postpartum on Pelvic Floor Muscle Function and Prevalence of Pelvic Floor Dysfunction 12 Months Postpartum

There is limited knowledge on how exercise impacts the pelvic floor muscles (PFM) and prevalence of stress urinary incontinence (SUI) and pelvic organ prolapse (POP) postpartum. The purpose of this study was to investigate whether early onset of general exercise postpartum negatively affects the PFM and/or increases the risk of SUI and POP 12months postpartum. This study used a prospective cohort design. At 6weeks postpartum, 57 women classified as exercisers (exercising ≥3 times at ≥30min/wk) were compared with 120 nonexercisers (mean age=29 years, SD=4.3). Manometry was used to measure vaginal resting pressure, PFM strength, and PFM endurance, and symptoms of SUI and POP were assessed using questionnaires. Data were presented as standardized beta coefficients (B) and odds ratios (OR). No differences were found between exercisers (n=57) and non-exercisers (n=120) at 6weeks postpartum on vaginal resting pressure (B=-0.04 [95% CI=-3.4 to 2.1]), PFM strength (B=0.03 [95% CI=-4.7 to 7.4]), PFM endurance (B=-0.02 [95% CI=-59 to 46]), or symptoms of SUI (OR=0.51 [95% CI=0.25 to 1.1]) or POP (OR=0.62 [95% CI=0.26 to 1.5]) measured at 12months postpartum. Adjusting for covariates, women with body mass index between 25 and 29.9 and>30 were more likely to report SUI 12months postpartum (OR=2.2 [95% CI=1.0 to 4.7] and OR=3.3 [95% CI=1.2 to 9.4], respectively). Women with physically strenuous occupations were more likely to report POP 12months postpartum (OR=3.0 [95% CI = 1.2 to 7.3]). This study suggests that regular exercise 6weeks postpartum has no negative effect on PFM function or on SUI or POP. Being overweight, however, was associated with more SUI, and women with physically strenuous occupations reported more POP. Results from this study suggest that first-time mothers should be encouraged to start general exercise within the first 6weeks after giving birth. Women at risk for PFD should be advised accordingly and potentially modifiable risk factors should be addressed prior to delivery. First-time mothers are encouraged to talk with a physical therapist about starting regular general exercise in the early postpartum weeks. Health care providers should advise patients on possible preventive measures for women at risk for PFD.

Prevalence of stress urinary incontinence and its impact on quality of life among women in Jordan: a correlational study.

ObjectiveThe study investigated the prevalence and impact of stress urinary incontinence (SUI) among women in Jordan.MethodsA correlational study was conducted to evaluate 500 Jordanian women aged >20 years. Women with symptoms of dementia, delirium, neurodegenerative changes and osteodegenerative changes were excluded. Data were collected using self-administered questionnaires (Arabic version of the Urogenital Distress Inventory-6 and Incontinence Impact Questionnaire (IIQ-7) short forms).ResultsA total of 200 (40%) women reported SUI; 47% reported mild symptoms, 37% reported moderate symptoms and 16% reported severe symptoms. There were positive correlations between SUI prevalence and number of pregnancies, age and obesity. SUI had a substantial impact on all aspects of quality of life (QoL), as assessed by the IIQ-7.ConclusionsA moderate prevalence of SUI was reported. There was a significant association between development of SUI and age, higher body mass index and number of pregnancies. Because SUI is highly prevalent and has a major effect on QoL, healthcare professionals should inquire about this condition and refer patients to related specialties for treatment.

Prevention of Stress Urinary Incontinence in Women

Lower urinary tract dysfunction (LUTD), including stress urinary incontinence (SUI), is increasingly recognized as a public health issue due to the prevalence, individual burden, and societal impact. Women are disproportionately affected by UI and are exposed to unique events that affect LUT function including higher rates of LUT infection, childbirth, pelvic floor anatomic changes, and hormonal milieu. The majority of LUTD research and clinical practice has focused on treatment of the most affected subset of women, but there are millions of women living with urinary incontinence that do not seek advice or treatment, and the evidence base for prevention or detection of early symptoms is lacking. Individual factors such as sociodemographic elements, medical history, physical exam, and comorbidities have been well studied; however, the contribution of family and environmental factors is less well understood. Emerging data suggests that some types of high-impact physical activity in adolescence can confer increased UI risk later in life. Prenatal and postpartum pelvic floor muscle training appears to be beneficial in preventing SUI in some women. While certain individual risk factors for SUI have been identified, sociocontextual factors also affect health outcomes and can mediate an individual’s risk of disease. The social ecological model considers factors within the family/peer, community, and societal levels that can affect an individual’s health behaviors. Prevention research that investigates these multiple levels of influence on individual biology and behavior is a fundamental step to better understand the complex factors that impact bladder health and inform LUTS prevention agendas. In addition, strategies to educate girls and women and engage communities in bladder health promotion are essential in order to effectively disseminate scientific findings and implement intervention programs.

The prevalence of lower urinary tract symptoms based on individual and clinical parameters in patients with multiple sclerosis

BackgroundMost patients with multiple sclerosis (MS) suffer from bladder dysfunction during the course of the disease. This study was conducted to examine the prevalence of these complications among patients with MS.MethodsThis cross-sectional study was performed on 602 patients with MS who referred to the neurology clinics of Kashani and Alzahra Hospitals affiliated to Isfahan University of Medical Sciences, Isfahan, Iran. Multistage random cluster sampling was performed and the informed consent form was signed by the subjects. Then, all the data were collected through interviews using the Lower Urinary Tract Symptom Score (LUTSS) developed in accordance with the definitions presented by the International Continence Society (ICS) and the International Prostate Symptom Score (I-PSS) and DASS-21 questionnaire. The data were analyzed using descriptive and inferential statistical tests in SPSS.ResultsThe prevalence rate of lower urinary tract symptoms (LUTS) was 87.6% among all the subjects, with a similar rate among women (88.0%) and men (86.0%). There was a significant difference between men and women in terms of the prevalence of stress urinary incontinence (SUI), intermittent urine flow, hesitancy, straining, and dribbling (P < 0.050). There was no significant difference between women and men in terms of the prevalence of other symptoms (P > 0.050). A significant difference was observed in the degree of LUTS with age, marital status, marriage duration, education, illness duration, clinical course, disability, anxiety, depression, and stress (P< 0.05). Moreover, logistic regression analysis revealed that there was a higher probability of a urinary problems among patients with MS and a high EDSS score [0.67 (0.507–0.903), P = 0.008].ConclusionsA high prevalence of LUTS was found among patients with MS. There was a higher probability of a urinary tract problem among patients with MS and a high EDSS score. Therefore, it is recommended that the health system take the necessary measures regarding timely detection and treatment of LUTS among these patients in order to prevent secondary outcomes and improve the quality of life (QOL) of patients with MS.

American Urogynecologic Society Systematic Review: The Impact of Weight Loss Intervention on Lower Urinary Tract Symptoms and Urinary Incontinence in Overweight and Obese Women.

Obesity can contribute to urinary symptoms such as urgency, frequency, and incontinence. In addition to classic treatments, weight loss interventions offer a unique clinical opportunity to improve these symptoms. The American Urogynecologic Society Systematic Review Group conducted a review of articles on the impact of surgical and behavioral weight loss (BWL) interventions on urinary symptoms in overweight and obese women. The certainty of the evidence was assessed using Grading of Recommendations Assessment, Development, and Evaluation criteria. The review group identified 43 publications from 39 studies, including 10 reports that used data from 5 randomized trials. Overall, there is high-certainty evidence that BWL, such as diet and exercise, decreases the prevalence of stress urinary incontinence 15% to 18% and overall urinary incontinence (UI) by 12% to 17% at 1 to 2.9 years. The certainty of evidence on the long-term impact of these interventions was lower. The certainty of the evidence was moderate to low regarding the benefit of BWL on urgency UI and overactive bladder symptoms. No randomized trials evaluated the impact of surgical weight loss on urinary symptoms, and the certainty of evidence of other study types was very low. There is high-certainty evidence that BWL results in modest improvements in stress and overall UI in overweight and obese women at 1 to 2.9 years after the intervention. Robust studies with low risk of bias are needed to assess whether these benefits are maintained over the long term and are associated with adverse events and to assess the impact of surgical weight loss interventions on urinary outcomes in overweight and obese women.

Prevalence of symptomatic urinary incontinence and pelvic organ prolapse among women in rural Nepal.

Although pelvic floor disorders (PFDs) are a significant public health issue in higher income countries, less is known about these disorders and associated risk factors in low income countries. We aimed to determine prevalence and associated risk factors for stress urinary incontinence (SUI), urge urinary incontinence (UUI), and pelvic organ prolapse (POP) in reproductive age women in Sarlahi District in rural Nepal. We conducted a community-based cross-sectional survey of parous, reproductive age women in rural Nepal and screened for pelvic floor disorders using validated screening questions for PFDs. Overall frequency of self-reported symptoms for SUI, UUI, and POP was estimated and compared across demographic and pregnancy history information. Of 14,469 women available for analysis, the mean (SD, range) age was 33.5 (8.2, 13-52) years, and median (range) number of pregnancies was 4 (1-15). The prevalence of SUI was 24.1% (95% CI: 23.3-24.8), of UUI was 13.5% (95% CI: 13.0-14.1), and of POP was 8.0% (95% CI: 7.5-8.4). Bivariate analysis identified the risk of PFD increased incrementally with age and number of vaginal deliveries; these covariates were highly correlated. Multivariable logistic regression revealed age, vaginal deliveries, and previous pelvic surgeries were independently associated with PFD. PFDs are common in a community of parous, reproductive age women in rural Nepal. Risk factors for these conditions are similar to risk factors found in higher income countries.

Prevalence and associated risk factors of urinary incontinence and dyspareunia during pregnancy and after delivery

ObjectiveThe objective of this study is to estimate the prevalence of dyspareunia and stress urinary incontinence (SUI) during pregnancy and after delivery, in addition to evaluating possible associated risk factors. Study designA cross-sectional study was conducted in 2016 with the target population being women who had given birth within the previous 12 months (n = 6436) in Galicia (Spain). Information was collected regarding the mother's status 6 months before pregnancy, during pregnancy, at the time of delivery, and at the time of the survey. The prevalence of SUI and dyspareunia were estimated and regression models were performed to identify variables associated with both pathologies. ResultsThe prevalence of SUI and dyspareunia after delivery were 20.4 % (CI95 %: 19.2–22.0) and 23.4 % (22.3–24.8), respectively. The presence of dyspareunia during pregnancy (adjusted prevalence ratio PR 2.1), breastfeeding (PR 1.2), and having a history of episiotomy (PR 1.3) were all variables associated with the presence of dyspareunia after delivery. SUI after delivery was related to the mother's history of SUI before pregnancy (PR 2.4) and during pregnancy (PR 2.0), as well as having undergone vaginal delivery (PR 2.0). ConclusionKnowing which factors are associated with the manifestation of SUI and dyspareunia in women after delivery is useful for identifying susceptible or "at risk" patients. These variables should be included in the clinical history of every pregnant woman.

Pelvic floor muscle displacement during jumps in continent and incontinent women: An exploratory study.

The prevalence of stress urinary incontinence during high-impact activities is high. Enhanced comprehension of pelvic floor muscle (PFM) displacement and activity is clinically relevant for the development of specific approaches in rehabilitation. The aim of the study is to investigate and to compare PFM displacement between the continent and incontinent women during jumps. A cross-sectional, exploratory design was applied to investigate PFM displacement during drop jumps (DJ) and countermovement jumps (CMJ). PFM displacement was assessed in craniocaudal translation and forward-backward rotation with an electromagnetic tracking system. Twenty-eight continent and 22 incontinent women were included. During the first landing of DJ, a primary caudal, during the second landing of DJ/CMJ a primary cranial translation and during all jump a primary backward rotation was observed. No significant difference between the groups was found. PFM displacement during running demonstrated caudal translation/forward rotation before and cranial translation/backward rotation after heel strike. During the second landing of DJ/CMJ a cranial translation/backward rotation and during the first landing of DJ a caudal translation/backward rotation has been observed after ground contact. This may be due to the longer lasting bodyweight force in the first landing of DJ. No eccentric-concentric stretch-shortening cycle could be seen. This study indicates that during jumps two opposite reactions of involuntary PFM displacement happen, but no stretch-shortening cycle with an eccentric-concentric contraction could be found. Jumping stimuli inducing involuntary PFM displacement should be used for future investigations to consider a beneficial effect concerning continence.

Urinary incontinence among competitive rope-skipping athletes: a cross-sectional study.

The purpose of this study was to determine the prevalence, impact and management of stress urinary incontinence (SUI) among rope-skipping (RS) athletes. A cross-sectional observational study was employed. Survey #1 (current athletes): RS athletes aged ≥13years attending a national RS competition (183) were invited to participate. The primary outcome was the prevalence of SUI during RS (yes/no question). Secondary outcomes included SUI interference with RS (Likert scale, 0-10), quality of life (ICIQ-SF), and the prevalence and bothersomeness of SUI for each RS event (un-validated sport-specific questionnaire inspired by the IIQ-7). Survey #2 (retired athletes): retired RS athletes were invited to complete an online questionnaire to identify whether SUI contributed to their retirement from RS. Survey #1: 56% (103 out of 183) of athletes responded. Athletes were predominantly girls of adolescent age, normal weight, menarchal, and nulliparous. Seventy-five percent of the girls (67 out of 89) and 7% of boys (1 out of 14) reported SUI during RS, mostly when competing "double-unders" and "triple-unders." Twenty-one percent (14 out of 67) of affected girls indicated a moderate or greater interference of SUI with RS, although the median impact of SUI on their overall quality of life was slight. Female athletes managed SUI with containment products, fluid limitation, and timed voiding. Survey #2: one of the 77 respondents (74 females, 3 males) indicated that SUI contributed to their retirement from RS. Similar to other high-impact sports, female RS athletes experience a relatively high rate of SUI while participating in RS, which may lead to decreased quality of life.

Physical Activity and Stress Incontinence in Women.

This review aims to discuss the current literature addressing associations between physical activity and stress urinary incontinence in women. Multiple cross-sectional studies utilize survey questionnaires to determine prevalence of stress urinary incontinence, impact of various types and intensities of physical activity on stress urinary incontinence, and explain differences in urinary symptoms among active women. Although there is evidence for increased rates of stress incontinence among women who are physically active, pathophysiology is not fully understood and there is a need for additional research exploring changes to the pelvic floor during exercise. Future research focusing on the mechanism in which physical activity contributes to urinary symptoms can guide development of primary preventions for stress urinary incontinence.

Pure stress urinary incontinence: analysis of prevalence, estimation of costs, and financial impact

BackgroundThe prevalence of pure stress urinary incontinence (P-SUI) and the role of urodynamic investigation (UDI) prior to surgery for stress urinary incontinence (SUI) is debated. Since the exact prevalence of P-SUI is not clear, its clinical and economic impact is not well defined. The aims of this study were to evaluate the prevalence of P-SUI in a population of women who underwent UDI for urinary incontinence (UI), also assessing: 1) the correspondence between clinical diagnosis of P-SUI and urodynamic findings; 2) the analysis of costs in terms of UDI and eventually post-UDI avoided surgical procedures.MethodsA single cohort of women who underwent UDI for UI between January 2012 and July 2016 was prospectively collected and retrospectively analyzed. Clinical P-SUI was defined by the strict criteria of the International Continence Society. For each patient, history, physical examination and UDI were collected. The correspondence between clinical and urodynamic findings of P-SUI was analyzed. The rate of clinical P-SUI changed after performing UDI and the number of unnecessary intervention after UDI were reported. A wide cost analysis of UDIs, and the amount of surgical procedures that were believed unnecessary after UDI was reported.ResultsStress urinary incontinence was present in 323/544 (59.4%) patients. The prevalence of clinical P-SUI was 20.7% (67/323), while the prevalence of complicated SUI (C-SUI) was 79.3% (256/323). After UDI, diagnosis of P-SUI decreased to 18.3% (59/232). In 10.2% of cases (6/59) the scheduled middle urethral sling (MUS) was suppressed after the UDI results because 3/6 cases had detrusor overactivity and urge incontinence, in 2/6 cases SUI was treated with a conservative management, in 1/6 case an important voiding dysfunction was detected. Considering the national reimbursement in our country, the cost of each UDI was 296.5 euros and the total amount was 17,493.5 euros. So far the surgery-related savings covered 61.7–105.0% of the costs of total number of UDIs performed in the uncomplicated patients.ConclusionsThe prevalence of clinical P-SUI is relevant, involving about 20% of women with clinical SUI. Although the correspondence between clinical and urodynamic diagnosis was high, we demonstrated that UDI may help in some cases to avoid an inappropriate surgical treatment. Therefore, UDI prior to SUI surgery should be considered to achieve a correct diagnosis and a proper therapeutic strategy.